Patient Forms
Our Forms
What You May Need
Release of Records
Complete this form if you have records and/or X-Ray films at another office that you’d like sent to us.
Injured in an Auto Accident?
Complete this form if you were injured in a motor vehicle accident.
New Patient Packet
Contains Patient Registration, Current Condition Form, Patient History Form, HIPAA, Financial Policy, and Terms of Acceptance. Open in Adobe Reader or Acrobat for fill-able form fields.
Insurance Assignment
This form is for when you want us to bill insurance or a party other than yourself.
Injured at Work?
Complete this form if you were injured at work.
Opening an LNI Claim?
Get more information here:
You can also start your claim by filling out a Report of Accident here:
Don’t worry, you can also fill it out on paper in our office, if that is your preference. If you open a claim online – don’t forget to let us know!
Get Connected
Chiropractic Hours of Service
Monday 10:00 AM – 1:00 PM & 2:00 PM – 6:00 PM Tuesday 9:00 AM – 1:00 PM & 2:00 PM – 6:00 PM Wednesday 9:00 AM – 1:00 PM Thursday 9:00 AM – 1:00 PM & 2:00PM -6:00 PM Friday 9:00 AM – 1:00 PM & 3:00 PM – 6:00 PM Saturday 9:00AM – 4:30 PM Massage Only Sunday Closed
Contact Us
3017 E Francis Ave, Suite 101
Spokane WA, 99208
Phone – (509) 467 – 7991
Fax – (509) 467 – 4834
frontdesk@spokanechiropractic.com
